| NPI | 1306147517 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA LAC1249)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA CRC00109065)  | 
| Enumeration Date | 2010-11-04 | 
| Last Update Date | 2010-11-04 |